Volar Locking Compression Plate Research Articles

Outcome analysis of fracture lower end radius (Ao Type B & C) treated by ORIF and plate

Treatment of distal radius fractures is difficult due to comminution and joint involvement. Plating is now the standard treatment method for distal radius articular fractures because of higher rate of complications after conservative management. The aim of the study was to evaluate the usefulness of volar lokcing plate fixation method of distal radius fracture and to compare it with other results.We ealuated 28 patients from volar locking plates from December2012 to March 2017, treated for distal radius intraartiular fractures by using a volar locking compression plate. Standard X-ray and clinical assessment after 1year were measured and final outcome were assessed using modified Gartland and Werley score. At the end of 12 months, 17 cases out of 28 cases in which most of the excellent results in AO type B fractures (excellent oucome in 13patients out of 16patients i.e. 81.25% cases) as compared to type C fracture where it was 33.33% cases (excellent outcome in 4patients out of 12patients). One case developed of superficial wound infection which resolves with antibiotics. The distal radius fixation volar locking plate restores anatomy, helps in speedy movement of wrist and function, prevents postoperative collapse of fracture and hence is an excellent treatment method for distal radius fractures.

To compare the functional and radiological outcome between external fixation and volar plating for the treatment of intraarticular distal end radius fractures

Background: Fracture of distal radius may be stable that is extra-articular, non-comminuted without distal radio ulnar joint disruption or unstable that is intra-articular, comminuted displaced with distal radio ulnar joint disruption. Complications of unstable fractures are shortening due to bone loss or due to resorption of the cancellous bone from metaphysis, resistant deformity, residual pain, late collapse, radio carpal arthritis and gross functional impairment. Aims and Objective: The purpose of this study to compare the relative efficacy of external fixation versus plating with regard to functional and radiological outcome. Materials and Methods: Total of 60 patients having intraarticular distal end radius fracture were included in this study and was equally divided into two groups, one group treated by external fixator other group with volar locking compression plate with or without augmentation by k-wire. Follow-up was done after 2 weeks, 4 weeks, 6 weeks and 3 ,6 and 12 months. The radiological evaluation was performed with Sarmiento’s Modification of Lindstrom’s Criteria. With the Modified Mayo Wrist Score, the patient’s functional outcomes were assessed and both groups were compared. Results: In this study we found that volar plate group had good to excellent outcome in 73% cases and 07% with fair outcome however with external fixator group found good to excellent in 50% cases and poor in 17% cases. Conclusion: In our study, we showed that the use of an external fixator and a volar locking plate for the treatment of intraarticular distal radial fractures were reliable. The relative simplicity of use, low surgical exposure, and decreased surgical trauma are benefits of external fixation. Despite these volar locking plates augmented with or without k wire had a good to excellent results in terms of early rehabilitation and less complications related to wrist joint. External fixator with ligamentotaxis provide significant good results in communited intraarticular distal end radius fracture.

FUNCTIONAL OUTCOMES OF DISTAL RADIUS FRACTURES MANAGED WITH 2.7MM VARIABLE ANGLE VOLAR LOCKING COMPRESSION PLATES

Objective: About 15 to 17 % of all fractures presenting to emergency department constitutes the distal radius fracture. Intra-articular fracture of distal radius remains one of the most challenging fractures to be reduced over decades for orthopedic surgeons. Objective is to demonstrate the functional outcomes of 2.7mm variable angle volar locking compression plate using Mayo’s wrist score in distal radius fracture.
 Methodology: A Quasi experimental study was conducted in the Department of Orthopedics & Trauma, CMH Rawalpindi from 20th October 2020 to 19th April 2021. A total of 120 patients with distal radius fracture AO Classification A1 C2 C3, 19 to 69 years of age of both genders were included. Outcome of 2.7mm Variable angle Volar Locking Compression Plates using Mayo’s wrist score was calculated. Data was entered in SPSS version 25. Descriptive analysis was done for age. Gender and mayo wrist scoring criteria were presented as frequencies and percentages. To analyze association of the outcome with age and gender chi-square test was applied.
 Results: Mean age in the study was 40.34 ± 8.01 years. Majority of the patients 71 (59.17%) were between 19 to 40 years of age. Out of 120 patients, 82 (68.33%) were males and 38 (31.67%). 51 (42.50%) patients had excellent functional outcome, 47 (29.17%) had good outcome, 13 (10.83%) had fair outcome and 09 (7.50%) had poor outcome.
 Conclusion: The functional outcomes of 2.7mm volar locking compression plate using Mayo’s wrist score in distal radius fracture is very good.

Distal radius fractures: a prospective study of the clinical and radiological outcomes in surgically managed patients

<p class="abstract"><strong>Background:</strong> Objective of the research was to evaluate radiological and functional outcome in fractures of the distal radius treated by various surgical methods.</p><p class="abstract"><strong>Methods:</strong> 89 patients with distal radius fractures were randomly divided into three groups according to a computer-generated table of randomization. 40 patients were managed by K wire fixation. 22 patients were managed by external fixator. 27 patients were managed by volar plating technique. Anatomical restoration was evaluated by posterior-anterior and lateral radiographs obtained preoperatively and at 09 months of follow up to evaluate radial height (RH), radial inclination (RI) and volar tilt (VT). Functional outcome was evaluated using Mayo scoring system.<strong></strong></p><p class="abstract"><strong>Results:</strong> According to Mayo score, in K-wire group 72.5% (n=29) patients had excellent to good outcome, 17.5% (n=7) had fair outcome while as 10% (n=4) patients had poor outcome. In external fixator group 72.7% (n=16) patients had excellent to good outcome while as 27.3% (n=6) had fair outcome. In volar plating group 81.5% (n=22) patients had excellent to good outcome while as 18.5% (n=5) had fair outcome.</p><p class="abstract"><strong>Conclusions:</strong> In our study we found that volar locked plating provides advantage in dorsally or volarly displaced intra-articular fractures with excellent to good radiological outcome. However, in type B (partial intra-articular fractures) fractures, volar locking compression plate (LCP) and external fixator provide almost equivocal results. Percutaneous pinning can be recommended for extra-articular or simple intra-articular fracture patterns, with a loss of volar and/or RI but without significant radial shortening.</p>

Functional and radiological outcome measures of surgically treated unstable distal radius fractures using a variable angle volar locking compression plate

Background: Various treatment modalities have been described to manage unstable distal end radius fractures. The use of variable angle volar locking compression plates is promoted for the management of these difficult fractures. Objectives: Objective was to evaluate the clinical and radiological outcomes in surgically treated unstable distal radius fractures with variable angle volar locking compression plates. Patients and Methods: We reviewed 23 out of 36 unstable distal end radius fractures that were surgically treated with variable angle volar locking compression plates at our institute. The mean age of these patients were 32.82 _ 11.81 years (range 19 to 62) and the mean follow-up duration was 11.04_2.47 months (range 6 to 15). All of them underwent open reduction and internal fixation with a variable angle volar locking compression plate. Radiological parameters measured were radial inclination, length, tilt, and ulnar variance. These were measured at six weeks and at the final follow up. The functional evaluation was by measuring the range of motion at the wrist and the grip strength. To assess the final outcome Gartland and Werley’s demerit scoring system was used.

Three Column Fixation Through a Single Incision in Distal Radius Fractures.

Purpose The purpose of this study was to evaluate the clinical and functional results of 67 patients with distal radius fracture (DRF), treated with a modified surgical technique that allows three-column fixation through the same palmar approach. Patients and Methods Between 2014 and 2019, we treated 67 patients using a particular surgical technique. All patients suffered DRF, classified using the universal classification system. Two different intervals were developed palmary: the first ulnarly to the flexor carpi radialis tendon for direct visualization of the distal radius and the second one radially to the radial artery for direct visualization of the styloid process. An anatomic volar locking compression plate was applied to all patients. The radial styloid process was fixed and stabilized either with Kirschner-wires or an anatomic plate through the same incision. Functional results were evaluated based on the Disabilities of the Arm, Shoulder and Hand and Mayo wrist scores. Range of motion and grip strength of the injured wrist were statistically compared with the opposite side. Results The mean follow-up was 47 months (13-84). All fractures were united, and all patients recovered to the preinjury level of activity. The mean flexion-extension range was 73.8° to 55.2° and the supination-pronation range 82.8° to 67°. No infection or nonunion occurred. No major complications were reported. Conclusion Open reduction and internal fixation, under specific indications, is the best treatment option in DRF. The described technique provides excellent visualization to the distal radius surfaces and allows the internal fixation of the radial columns through the same skin incision. Therefore, it can constitute an efficient choice in the treatment armamentarium of DRF.

Surgical management of fractures of distal end radius with open reduction and internal fixation using volar locking compression plate

Backgrounds and Objectives: Fractures of distal end of the radius are one of the most common injuries which lead to approximately 1/6th of all fractures which are observed and treated.Failure to achieve and also to maintain anatomic restoration may lead to various deformities and disabilities, poor functional outcome (usually seen with cast immobilization of intraarticular fractures)Later studies have advised operative intervention with conventional T buttress plates, and more recently volar locking compression plates whose mechanical advantage justifies its vast usage. The principle of the Locking Compression Plate is to have rigid fixation close to the bone and under the soft tissue envelope. Locking Compression Plates are anatomically designed plates to maintain alignment and to prevent collapse of the fracture fragment.Methods: This study is a prospective, time bound, hospital based study that was conducted in kempegowda institute of medical sciences and research centre, Bangalore between October 2018 and May 2020. The study included a total of 30 cases of distal end radius fractures that were operated with open reduction and internal fixation with volar Locking Compression Plate (volar LCP).The fractures were classified according to Frykmann classification and were followed up at regular intervals. Functional outcome was assessed using the Gartland and Werley demerit scoring at each follow up visit.Results: Our study revealed nearly half of the study population with excellent outcome (47%), good and fair outcomes were noted among 40% and 13% respectively while none of the patients had poor outcome.Most fractures united by 12 weeks. Complications associated were stiffness, arthritis and EPL tendon irritation.Conclusion: The present study demonstrates well to excellent results in the majority of patients based on G&W functional outcome evaluation after locking plate fixation of the lower end distal radius with lower rate of complications.

Radiological outcomes of AO type B and C distal radius fractures managed with 2.7 mm volar locking plate fixation in geriatric population: a retrospective analysis

<p class="abstract"><strong>Background:</strong> Distal end radius fractures are one of the most common fractures. Compared to younger patients, elderly with distal radius fractures with osteoporosis and higher comminution compromise the treatment outcomes. Anatomic reduction with stable fixation is usually the choice of treatment for displaced intra-articular fractures. While osteoporosis and poor bone quality hamper fracture stabilization, locking compression plates (LCPs) provide enhanced stability and axial loading force as compared to conventional plates. The current study retrospectively analysed the postoperative radiological outcomes in a 2.7 mm volar LCP system used for internal stabilisation of intra articular distal radius fractures.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was conducted in the Sanjay Gandhi institute of trauma and orthopaedics, Bangalore from June 2018 to July 2020. All Arbeitsgemeinschaft für Osteosynthesefragen (AO) type B and C distal radius fractures of patients aged 60 and above who underwent 2.7 mm volar locking plate fixation during that time period were analysed with X-rays at immediate post-operative, six weeks and three months. The radiological outcome was scored based on Sarmiento’s modification of Lindstorm criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean immediate post-operative radial shortening, decrease in radial deviation and loss of palmar tilt were 3.80±1.03, 4.38±1.05 and 3.97±1.02, respectively. The corresponding values at last follow up were 4.31±1.12, 6.19±1.02 and 4.76±0.99, respectively. No statistically significant difference (p=0.949; p=1.0; p=0.996) in radial shortening, loss of radial deviation and decrease in palmar angulation was seen till the final follow up. Sarmiento’s modification of Lindstorm criteria showed a good radiological outcome in 80% and excellent in 20%.</p><p class="abstract"><strong>Conclusions:</strong> Use of 2.7 mm volar LCP showed good to excellent post-operative radiological outcomes in geriatric population. The fracture reduction achieved in the immediate post-operative period is maintained throughout the follow up duration without any significant change.</p>

Study of treatment for distal end radial fractures by open reduction and internal fixation with volar locking compression plates

Introduction: For dorsally displaced lower end radius fractures percutaneous pinning fixation and insome studies fragment specific fixation shows their advantages. For volarly displaced fracturesvolarly plate fixation traditionally showed good results. The volar locking plates with their inheritanceability to provide absolute stability are attractive for their advantages. Objective: To assess thefunctional outcome of treating the distal end radius fractures with the use of volar lockingcompression plates. Materials and methods: Study of a total of 30 patients was conducted in thedepartment of orthopedics at G K General Hospital, Bhuj, Gujarat. All 30 patients with closedfractures were included in the study. All patients were treated with open reduction and internalfixation with the use of a volar locking compression plate. The patients were followed up at one, two,three, and up to six months. Mayo wrist scoring system was used to assess final functional outcomesof treatment. Results: At the final functional assessment, as per mayo wrist scoring out of a total of30 patients, 17 of them achieved excellent, 7 achieved good outcomes, with 5 patients exhibitingfair results and one patient had the collapse of fixation at the 3-month review. No, any patient haddiminution of functional outcome. On radiological assessment, 70% of patients had callus formationand no clear fracture line was seen, 18% had callus formation but a visible fracture line was presentand 12% of patients had clear visible fracture line up to final follow up. Conclusion: Open reductionand internal fixation with volar locking compression plating is a safe and effective treatment forunstable especially volarly displaced fractures of distal end radius with satisfactory functionaloutcome.

Study the functional outcome of Barton’s fracture treated with open reduction and internal fixation by volar plating: A prospective study

Aims: To study the functional outcome and duration of union of surgical management of Barton’s fracture of distal radius with volar locking compression plate fixation.Settings and Design: Prospective studyMethods and Material: 56 cases presenting with Barton’s fracture which satisfies inclusion and exclusion criteria admitted in Shri B.M. Patil college, hospital and research centre vijayapura from 2017-2020 who are treated with volar locking plate.Results: In our study 56 cases, there were 29 males, 27 females with mean age of 39.52 years. 85.7% were admitted due to fall on outstretched hand, left side was more common according to 57.1% cases, associated ulnar fractures were found in 76.8% cases. 89.3% cases didn’t have any co-morbidity. 89.3% of the patient had no complication following surgery. Most common complication was wrist stiffness in 7.1% cases followed by surgical site infection 1.8% and complex regional pain syndrome in 1.8% cases according to Disability of Arm, Shoulder and Hand (DASH) score.Conclusions: Initial reduction and stable fixation is the key in prevention of late collapse of distal radius fractures. Stabilizing the fracture fragments with volar locking compression plate and screws in the management of fractures of distal radius is an effective method to maintain reduction and prevent collapse of the fracture fragments. The technique emphasizes that open reduction and internal fixation with volar plating has excellent functional and satisfactory radiological outcome with minimal complications. Hence volar approach and locking compression plate should be the preferred implant for treatment of intra- articular unstable, comminuted fractures of distal end radius.

Functional and radiological outcomes in 2.7-mm volar locking compression plating in distal radius fractures

BACKGROUND: Bio-mechanical studies have shown volar locking compression plates (LCPs) to have higher rigidity and stability as compared to traditional plates, but lacunae exists with regard to the use of 2.7-mm volar LCP. AIMS: The aim was to prospectively assess the postoperative functional and radiological outcomes in a 2.7-mm fixed-angle volar LCP , to analyze factors influencing the functional and radiological outcomes, and to correlate patient's perception of recovery with the radiological outcome. SETTINGS AND DESIGN: This was a descriptive study with a prospective longitudinal study design conducted at a tertiary care hospital. MATERIALS AND METHODS: Thirty patients who underwent fixation of distal radius fracture with a 2.7-mm fixed-angle buttress-type volar LCP were followed up for functional and radiological outcomes at 6 weeks, 3 months, and 6 months after surgery using standardized scoring systems. STATISTICAL ANALYSIS: Descriptive statistics was used for statistical analysis. RESULTS: Use of 2.7-mm fixed-angle volar LCP was found to have good to excellent functional and radiological outcome in majority of the cases. A significant correlation existed between the functional and radiographic outcome. Patient-rated wrist evaluation had a significant inverse correlation with the radiological outcome. We did not find any significant association of the functional or radiological outcome with age, sex, dominance of the injured hand, and the fracture type. The fracture reduction achieved in the immediate postoperative period was maintained throughout the follow-up duration. CONCLUSION: This study effectively demonstrates the optimal results in terms of postoperative functional and radiological outcomes with the use of 2.7-mm volar locking plate for distal radius fracture fixation.

A retrospective analysis comparing functional and radiological outcomes after treatment of unstable distal radius fractures using volar locked plate versus percutaneous fixation

<p class="abstract"><strong>Background:</strong> Distal radius fractures are one of the most routinely encountered injuries in an orthopaedic setting. Despite the wide variety of treatment options available there is still debate about the optimal way to treat these fractures. The aim was to evaluate and compare functional and radiological outcomes of unstable distal radius fractures treated by either by using volar locking compression plating (VLP) or by using percutaneous fixation augmented by Kirschner (K) wires (EF).</p><p class="abstract"><strong>Methods:</strong> A retrospective analysis was carried out on all cases of acute unstable unilateral fracture distal radius who were admitted between January 2015 and December 2017 and were treated either by VLP or EF. QuickDASH score and PRWE were documented at every follow up in OPD at 6 weeks, 6 months and 1 year post-op along with serial X-rays at immediate post-op and 01 year which were then compared.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 122 cases of fracture distal radius were selected for study which fulfilled the inclusion criteria out of which 49 were treated by VLP and 73 by EF. There was no statistical difference in QuickDASH, PRWE scores or wrist ROM between two groups at1 year follow up. However VLP group was better in maintaining palmar tilt, radial length and inclination at the end of 1 year.</p><p class="abstract"><strong>Conclusions:</strong> Both VLP and EF show comparable and predictable good outcomes in treating unstable distal radius fractures when measured in terms of ROM and clinically validated patient outcome scores at 01 year follow up with similar rate of complications.</p><p> </p>

Study of clinicoradiological and functional outcomes in intraarticular distal end radius fractures managed by volar locking plate

<p class="abstract"><strong>Background:</strong> Various modalities of fixation are available for management of distal end radius fractures. Assessment of the functional and radiological outcomes of intra-articular distal end radius fractures managed with volar locking plate was attempted with the present study.</p><p class="abstract"><strong>Methods:</strong> In this prospective interventional study, thirty adult patients with closed distal radius fractures with intra-articular extension were comprehensively evaluated and managed. Open reduction and internal fixation (ORIF) was performed via volar approach (modified Henry`s approach) using 2.7mm volar locking compression plates (LCPs). Patients were followed up at 2 weeks, 1 month, 3 months and 6 months after surgery. The patients were evaluated functionally by Mayo score and radiologically by Lidstrom classification.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 18 (60%) patients having excellent, 8 (26.7) good, 2 (6.7%) fair and 2 (6.7%) with poor result according to Mayo scoring. According to Lidstrom scoring, at the last follow up, 16 (53.3%) patients had excellent, 11 (36.7%) patients good, 2 (6, 7%) patients fair and 1 (3.3%) patient had poor result. The functional status of the patient improved significantly from at 1month (20±3.47) to 6 months post-operative follow up (23.67±2.91). The mean range of motion improved significantly at 1 month, 6 months and last post-operative follow-up.</p><p class="abstract"><strong>Conclusions:</strong> Volar locking plate gives good to excellent clinico-radiological and functional outcomes in most of the fractures of the distal end radius with intraarticular extension.</p>

Functional and radiological outcomes of volar locking compression plate in surgical management of fractures of distal end radius

Background: Management of fractures of distal end radius has remained a controversial issue. They are treated via a variety of methods, but the best of treatment has not been defined yet. This study was performed to evaluate functional and radiological outcomes of volar locking plate in surgical management of such fractures. Material and Methods: In this prospective study 30 patients aged above 18 years of fracture distal end radius were treated with open reduction and internal fixation with volar locking plates, followed by early mobilization. Patients were followed up regularly and functional assessment were done at 3 weeks, 3 months and 6 months using modified Mayo wrist score. Results: Radiologically all patients had union at 3 months. 66.67% patients had excellent, 23.33% good and 10% showed satisfactory results on modified Mayo wrist score. No major complications were observed in the present study. One patient developed superficial infection which was resolved with serial dressing and broad spectrum antibiotics. Two patients developed hypertrophic scars. Two other patients developed asymptomatic hardware prominence (plate on radial border). Conclusion: Locking compression plate provides stable fixation for early mobilization of patient, leading to early resumption to pre trauma functional level of an individual with minimal complications.

A short term prospective study of the functional outcome of comminuted displaced intra-articular fracture of the distal radius treated with volar locking compression plate

Distal radius fracture accounts for approximately 17% of all fractures. More than half of these fractures are intra-articular and associated with Distal Radio Ulnar Joint (DRUJ) injuries. Several treatment modalities have been described like plaster cast, external fixation and open reduction and internal fixation with plate osteosynthesis. Superiority of open reduction and internal fixation with plate osteosynthesis has been established well, as it provide angular stability and allow for early mobilization, thereby achieving early functional recovery. In this prospective study, done over a period of 36 months and with a minimal follow-up of at least 12 months, we were able to recruit 56 patients conforming to our inclusion criteria. We had followed the Melone Classification and had operated all cases using the Ellis approach with distal radius volar side specific locking compression plates. We had evaluated the functional outcome of wrist function using the Demerit point system of Gartland and Werley at the end of 12 months of follow-up. Our study concluded that ORIF is an effective surgical management protocol for unstable intra-articular distal radius fracture. In our short term study the overall complication rate was 17.86%. The functional outcome excellent to good in 75% of cases, it was fair in 17.9% of cases and poor in only 7.1% of cases.

Comparison of volar locking compression plate Versus External Fixator in the Treatment of Distal Radius Fractures

Comparison of volar locking compression plate Versus External Fixator in the Treatment of Distal Radius Fractures

Outcome of fracture distal radius treated with open reduction internal fixation with volar locking compression plate (A study of 50 cases)

Introduction: Fractures of the distal radius constitute one of the most common skeletal injuries treated by Orthopaedic surgeons. These injuries account for one sixth of all fractures and represent 17% of all the fractures evaluated in emergency room. The use of strong implant in the form of Fixed Angle Volar Locking Compression Plate theoretically achieves, maintain the reduction and stability in displaced intra-articular & extra-articular distal radius fractures in both the economically productive young age group as well as in the osteoporotic elderly population with less bone stock.Hence, we have decided to study the results of management of distal radius fractures with the open reduction and internal fixation with Volar locking compression plates. Aim: To study the results of operative management of distal radius fractures in terms of functional and radiological outcome, with open reduction and internal fixation with Volar locking compression plates. Materials and Methods: This was a prospective study, where Fifty adult patients with distal radial fractures, treated with a volar locking compression plate using a Modified volar Henry approach(i.e flexor carpi radialis FCR approach), were included in this study. The fracture fragments were analyzed and involvement of radiocarpal and distal radioulnar joints were assessed and classified according to the Frykman’s and AO classification. First follow up of patients was done between tenth to fifteenth post-operative days Subsequent follow ups were done for three months at monthly interval.At each follow up clinical and radiological assessment was done using different parameters.Final assessment of the outcome was done after three months, by MAYO WRIST scoring system. Results and Discussion: In our series, we had 90% excellent, 6% good, 2%, fair and 2% poor result. Patients, who obtained excellent results, had no residual deformities or pain. Range of motion was within the normal functional range. Two patients (4%) had arthritic changes but no other complications. They were operated within 6 days after injury. Radial length, volar tilt and articular step-off were within acceptable limits. They were co-operative to physiotherapy. The results obtained in our series are comparable to other studies undertaken similarly. Conclusion: Use of locked compression plates in distal radius fractures provided good to excellent results with correction and maintenance of distal radius anatomy. By using these plates, joint motions and daily functioning were recovered in a shorter time.

Juxta-articular Plate Fixation in Distal Radius Intra-articular Fractures with Accompanying Volar Free Fragments beyond the Watershed Line.

BackgroundAlthough distal radius fractures (DRF) are common fractures, intra-articular comminuted DRF with volar free fragments are uncommon. There is considerable difficulty in the fixation of free fragments beyond the watershed line using the existing volar locking plate. We aimed to examine the efficacy and potential complications associated with the use of juxta-articular volar plates in intra-articular DRF accompanied by free fragments beyond the watershed line.MethodsThe patients were enrolled in a consecutive manner between 2007 and 2016. In cases of DRF with free fragments beyond the watershed line, we employed a 2.4-mm small fragment juxta-articular volar locking compression plate using a volar Henry approach. A total of 32 patients were included in this study. There were 15 males and 17 females with a mean age of 52.3 years (range, 33 to 69 years). The mean follow-up period was 14.5 months (range, 10 to 24 months). Preoperative radiographs and three-dimensional computed tomography images were used to analyze fracture patterns and assess the free fragments beyond the watershed line. The mean number of free fracture fragments beyond the watershed line was 2.33. Plain radiographs of immediate postoperative and last follow-up were used to confirm fracture union, incongruence, radial height, volar tilt, radial inclination, and arthritic changes. For functional assessment, we measured grip strength, range of motion (ROM), modified Mayo wrist score (MMWS) and determined Disabilities of Arm, Shoulder and Hand (DASH) scores at the last follow-up. Postoperative complications were monitored during the follow-up period.ResultsAll patients obtained sound union without significant complications. At the last follow-up, 16 cases presented with an articular step-off of more than 1 mm (mean, 1.10 mm). The mean MMWS was 76.3 (range, 55 to 90), mean DASH score was 15.38 (range, 9 to 22), mean visual analogue scale score for pain was 1.2 and mean grip strength was 75.5% of the opposite side. The mean ROM was 74.3° for volar flexion and 71.5° for dorsiflexion.ConclusionsIn cases of intra-articular DRF with free fragments beyond the watershed line, a volar approach with use of a juxtaarticular plate provided favorable outcomes without significant complications.

T-type comparison of locking compression plate versus variable angle locking compression plate in treatment of distal radial fractures

Objective To compare the clinical effects of the T-type volar locking compression plate and variable angle two-column locking compression plate in treatment of 118 cases with distal radial fractures. Methods Retrospectivly analyzed the clinical data of distal radius fracture cases from Dec. 2011 to Nov. 2015 in Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University who were respectively underwent T-type locking compression plate and variable angle two-column locking compression plate. The T-type locking compression plate group of 60 cases; according to AO/OTA classification, including 3 cases of type A3, type B2 5 cases, type B3 7 cases, type C1 10 cases, type C2 20 cases, type C3 in 15 cases. The variable angle two-column locking compression plate variable angle two-column locking compression plate group 58 cases; according to AO/OTA classification, including 1 cases of type A3, type B2 2 cases, type B3 4 cases, type C1 15 cases, type C2 18 cases, type C3 18 cases. Comparative analysis of two groups of postoperative radiographic parameters and functional recovery. Palm angle, ulnar deviation angle, radius height, wrist joint activity and G-W function score were measured by (±s), and the comparison was performed t test. Results All patients were followed up, mean follow-up time of T-type locking compression plate group was 26.5 months, the mean follow-up time of variable angle two-column locking compression plate group was 25.6 months. The results showed that there were no significant differences between the two groups in ulnar deviation angle, radius height, radial deviation angle and Gartland-Werley function score.There was significant difference between the two groups in the angle of palm angle, wrist dorsal extension, palmar flexion, ulnar deviation, Wrist rotation, and variable angle two-column locking compression plate had advantages. Conclusion Two kinds of treatment of distal radius fractures were satisfactory clinical efficacy, and variable angle two-column locking compression plate had more advantages, doctors can choose corresponding fixation methods according to the specific situation of patients. Key words: Radius fractures; Internal fixators; Fracture fixation, internal

Study of distal radius fracture treated with minimally invasive plate osteosynthesis technique

Objective: To study the results in terms of functional and radiological outcome of distal radius fractures treated with volar locking compression plates using MIPO technique. Introduction: Minimally invasive procedures decrease surgical damage as well as the incidence of complications. They have their main indication in patients with marked soft tissue lesions. Small incisions, made away from the fracture site, help to minimize further soft tissue injury during surgical stabilization, and they preserve bone vascularity, contributing to bone union and fewer complications. They were first used to treat complex lower extremity metaphysodiaphyseal and periarticular fractures that could not be treated properly using intramedullary nails. Subsequently, its application was expanded to include upper extremity fractures, mainly humerusfractures, but little has been published about its use in distal radius fractures [3]. Methodology: A cohort of 20 cases of distal radius fractures treated with MIPO Technique using volar locking compression plates during Jan 2016 to Sep 2016. Results: Out of 20 patients, 13 excellent (65%), 6 good (30%) and 1 fair (5%) and no poor results were obtained using Modified Gartland and Werley’s scoring system.